Vasectomy

What is a Vasectomy?

A vasectomy procedure is a form of permanent birth control (also know as sterilization) that has been available to couples for many decades. Over this time period, doctors and patients have found this to be a very safe procedure in the majority of instances. It is extremely reliable in preventing unintended pregnancies when compared to other forms of birth control such as birth control pills, condoms, and the natural or calendar method.

To better understand the process by which a vasectomy works, a basic understanding of the male reproductive anatomy is needed. The testicles are paired glands that reside in the lower portion of the scrotal sac. The testicles supply two main functions to the male body. The first function of the testicles is to produce testosterone, which is the male hormone that helps men develop normally through puberty, and also provides secondary benefits of sexual functioning and other male characteristics. The second function of the testicles is to produce sperm. Sperm are the cells that provide men with the ability to conceive a child. The sperm are released from the testicles and travel through the vas deferens, which are small tubes that connect the testicles with the urinary tract near the bladder. During sexual climax, sperm is released into the lower urinary tract where it mixes with other secretions and then expelled from the penis.

Preparation for the Vasectomy

One of your first tasks in preparing for your vasectomy is picking an appropriate date. We advise that patients refrain from physical activity for forty-eight hours following their vasectomy. Most patients thus desire to proceed with their vasectomy on a Thursday or a Friday which allows them two days at home to recuperate. Our office will be happy to assist you in scheduling your procedure on a convenient day.

Prior to the procedure, we ask that you perform a limited shave of the genital hair around the vasectomy site. Shaving the hair on the upper part of the scrotum in the front and sides is usually sufficient for this. Most patients find this is most easily accomplished by using a disposable razor during a hot shower.

On the day of the vasectomy, you may eat and drink normally. You may take your normal medications and supplements. We would ask, however, that you refrain from using any blood thinners for approximately one week prior to your vasectomy. Typical blood thinners contain aspirin products, ibuprofen, naproxen, vitamin E, fish oil, as well as more specific drugs that are utilized for specific cardiac and vascular diseases. If you have any questions as to whether or not you currently take a drug that thins the blood, please do not hesitate asking our office for further instruction.

The Vasectomy Procedure

On the day of the procedure, we ask you to arrange for someone to drive you to and from the procedure. The procedure takes approximately 15-20 minutes. Once in the procedure room, you will be asked to undress from the waist down, cover up with a sheet, and lay down on a procedure table. Once you are positioned on the table, a small amount of cleansing solution will be used to prepare the skin in the upper scrotal and genital region.

During a vasectomy, the vas deferens on each side of the scrotal sac is disconnected thus interrupting the flow of sperm from the testicles to the urinary tract. This is usually accomplished by placing a small amount of numbing medicine into the skin overlying the tube on each side. Most men report that this feels like a small pinch which lasts 1-2 seconds. Once this medicine is in place, there is very little pain for the remainder of the vasectomy. After the skin is numb, your doctor will make a small incision in the skin overlying the tube and then identify the tube underneath. Once isolated, the tube is disconnected to complete the vasectomy. These steps then are repeated on the opposite side to complete the procedure.

At the conclusion, a small stitch is usually placed to close the skin incisions. Typically, this stitch will dissolve over a period of one week, and thus a routine follow up for stitch removal is rarely needed. Your doctor will verify whether or not a follow up appointment is required.

After the procedure, you can dress and then travel home. We suggest having a supportive pair of underwear available to use immediately after the procedure and for at least one week following the vasectomy. Many patients use jockey shorts, boxer briefs, or an athletic supporter.

After Vasectomy Procedure

You are at greatest risk for complication from your vasectomy in the first 48 hours after the procedure. During this time period, the body will undergo the initial phases of healing. This is when inflammation is most prominent. Minimizing inflammation through the following techniques will thus minimize your pain and risk of complications following your procedure. The key instructions for you to following during this 48-hour period are as follows:

Immediately upon returning home, we ask you to refrain from being on your feet for any extended period of time. You do not have to be at strict bedrest; however, minimizing the time that you are on your feet will decrease the amount of swelling experienced in the scrotal and testicle region. Typically, men will sit on the couch, chair, or at the desk while working on non-strenuous activities.

On the day after your vasectomy, you may shower in the morning, but we again would ask you to spend most of the day following the vasectomy off of your feet.

For the first 48 hours, we suggest using an ice pack on the region to help reduce the amount of inflammation. This does not have to be a constant application of ice. A suggested regimen is 10 minutes on and 30 minutes off in order to keep the tissue slightly cool to help reduce the chances of swelling.

After the initial 48 hours following the procedure, you can them resume most activities. Most men find that in the first week after the procedure, they will occasionally get discomfort when they are on their feet for extended periods of time and when they are engaging in more moderate to strenuous activities. This is entirely normal and usually will respond to the use of ibuprofen or other anti-inflammatory medicine. Men also find that the use of form fitting underwear, as previously mentioned, also helps minimize the discomfort in the first week. We would ask you to consider refraining from elective strenuous activities such as running, biking, and gym work outs to help minimize the discomfort in this period of time.

You may resume sexual activity one week after your vasectomy.

When will I be considered sterile?

It takes several weeks for all sperm to exit the reproductive tract downstream from where your vasectomy is performed. What this means is that you are still fertile and pregnancy can still be achieved until all of the sperm exit the reproductive and urinary tracts. Several studies have been performed to verify the time period this requires; however, this is most accurately judged by examining a semen sample to verify that all sperm are removed from the tract. The typical time frame for this is two months following the procedure. Your doctor can verify this time period. Again, you are cautioned to continue some type of secondary birth control until this check can be performed and your vasectomy can be verified to have been successful. You will be given instructions and supplies following your vasectomy.